Method and system for integrating a computer aided dispatch system with an emergency medical dispatch protocol

ABSTRACT

An interface between a computer aided dispatch system and an emergency medical dispatch protocol is provided. Able to operate in either a resident or a non-resident mode, this invention coordinates the transfer of control and information between the computer aided dispatch system and the emergency medical dispatch protocol to improve the efficiency of emergency medical response resources while maintaining the certainty of the use of an established medical response and instruction protocol.

BACKGROUND OF INVENTION

[0001] 1. Field of the Invention

[0002] This invention relates to methods and systems for integratingcomputer applications. More specifically, this invention relates tomethods and systems for integrating a computer aided dispatch (CAD)system with a medical protocol interrogation process operating on acomputer system.

[0003] 2. Description of Related Art

[0004] A variety of computer software interface methods and systems havebeen proposed to provide an interface between two or more previouslydisconnected computer program methods. Generally, these prior systemsand methods are not adapted to function with a computer aided dispatchsystem and a medical protocol interrogation process.

[0005] The reader is referred to the following U.S. patent documents forgeneral background material. Each of these patents is herebyincorporated by reference in its entirety for the material containedtherein.

[0006] U.S. Pat. No. 5,857,966 describes a method and system forreceiving processing and responding to emergency medical calls forpatients who have fainted or are unconscious.

[0007] U.S. Pat. No. 5,989,187 describes a method and system forproviding emergency medical counseling to childbirth patients remotely.

[0008] U.S. Pat. No. 6,004,266 describes a method and system forreceiving, processing and responding to emergency medical calls forpatients with heart problems.

[0009] U.S. Pat. No. 6,010,451 describes a method and system forproviding emergency medical counseling to choking patients remotely.

[0010] U.S. Pat. No. 6,053,864 describes a method and system forproviding emergency medical counseling to arrest patients remotely.

SUMMARY OF INVENTION

[0011] It is desirable to provide a method and system for combining acomputer aided dispatch system with an emergency medical dispatchprotocol that provides an integrated dispatch system which enables acall taker to rapidly and safely navigate through the medical protocol,wherein key questions and answers are pre-determined in the logic of anexpert system to calculate an appropriate determinate level and therebythe appropriate emergency medical response. The determinate levelprovides a categorization code of the type and level of the incident,the code is provided to a Computer Aided Dispatch system, which is atool used by dispatchers to track and allocate emergency responseresources, for processing.

[0012] Accordingly, it is an object of this invention to provide aninterface between a computer aided dispatch system and an emergencymedical dispatch protocol.

[0013] Another object of this invention is to provide an interfacebetween a computer aided dispatch system and an emergency medicaldispatch protocol, which enhances the cooperation between the twoprocesses.

[0014] A further object of this invention is to provide an interfacebetween a computer aided dispatch system and an emergency medicaldispatch protocol, which operates in a multi-tasking environment.

[0015] A still further object of this invention is to provide aninterface between a computer aided dispatch system and an emergencymedical dispatch protocol, which enables a call-taker to rapidly, andconsistently navigate through a medical protocol.

[0016] It is another object of this invention to provide an interfacebetween a computer aided dispatch system and an emergency medicaldispatch protocol in which key questions and answers are pre-determinedin internal logic to generate an appropriate response determinate.

[0017] It is a further object of this invention to provide an interfacebetween a computer aided dispatch system and an emergency medicaldispatch protocol, which provides quality assurance procedures.

[0018] Another object of this invention is to provide an interfacebetween a computer aided dispatch system and an emergency medicaldispatch protocol that includes a reporting capability to measure theperformance of individual staff and overall center performance.

[0019] A further object of this invention is to provide an interfacebetween a computer aided dispatch system and an emergency medicaldispatch protocol that provides a standardized coding system for use inthe computer aided dispatch system.

[0020] A still further object of this invention is to provide aninterface between a computer aided dispatch system and an emergencymedical dispatch protocol that communicates the type and level ofcriticality of the incident from the protocol to the computer aideddispatch system.

[0021] A further object of this invention is to provide an interfacebetween a computer aided dispatch system and an emergency medicaldispatch protocol that, in combination with a computer aided dispatchsystem and the protocol, provides the means of tracking and allocatingemergency medical resources.

[0022] Additional objects, advantages and other novel features of thisinvention will be set forth in part in the description that follows andin part will become apparent to those skilled in the art uponexamination of the following or may be learned with the practice of theinvention. The objects and advantages of this invention may be realizedand attained by means of the instrumentalities and combinationsparticularly pointed out in the appended claims. Still other objects ofthe present invention will become readily apparent to those skilled inthe art from the following description wherein there is shown anddescribed the preferred embodiment of this invention, simply by way ofillustration of one of the modes best suited to carry out thisinvention. As it will be realized, this invention is capable of otherdifferent embodiments, and its several details and specific steps arecapable of modification in various aspects without departing from theconcept of this invention. Accordingly, the objects, drawings anddescriptions should be regarded as illustrative in nature and not asrestrictive.

BRIEF DESCRIPTION OF DRAWINGS

[0023] The accompanying drawings incorporated in and forming a part ofthe specification, illustrate a preferred embodiment of the presentinvention. Some, although not all, alternative embodiments are describedin the following description. In the drawings: FIG. 1 is a top-levelsystem block diagram showing the preferred computer hardware employed inthis invention.

[0024]FIGS. 2a and 2 b are flow diagrams of the preferred steps of thenon-resident mode integration process of this invention.

[0025]FIG. 3 is a flow diagram of the preferred reopen procedure of thisinvention.

[0026]FIG. 4 is a flow diagram of the preferred case summary procedureof this invention.

[0027]FIG. 5 is a flow diagram of the preferred startup procedure ofthis invention.

[0028]FIG. 6 is a flow diagram of the preferred shutdown procedure ofthis invention.

[0029]FIGS. 7a and 7 b are flow diagrams of the preferred steps of theresident mode integration process of this invention.

[0030]FIG. 8 is a flow diagram of the preferred case summary procedureof this invention.

[0031] Reference will now be made in detail to the present preferredembodiment of the invention, an example of which is illustrated in theaccompanying drawings.

DETAILED DESCRIPTION

[0032] This invention is a method and system for combining andfacilitating the operation of a computer-aided dispatch (CAD) systemwith an emergency medical dispatch system which enables an emergencycall taker to rapidly, safely and consistently navigate through anemergency medical protocol.

[0033] CAD is a tool used by dispatchers to track and allocateresources. The primary information used in this task is locationinformation of both the incident and units, unit availability and thetype of incident. CAD systems typically use third party solutions, suchas E-911, vehicle location transponders and MDT's for automating thelocation and availability tasks.

[0034] In its present preferred embodiment, this invention works with asoftware expert system, wherein key questions and answers are processedaccording to predetermined logic to both provide the correct emergencymedical dispatch response and the appropriate doctor-approvedpost-dispatch instructions to the call taker before professional helparrives. The reader should note that for the purposes of thisdisclosure, the following terms shall be treated as synonyms, in thepresent preferred embodiment of the invention: expert system, softwareexpert system, medical dispatch system or program, emergency medicaldispatch expert system, ProQA and derivations thereof. The softwareexpert system calculates a determinate value from the caller's responsesand uses this determinate value to present the appropriate response foruse by the dispatcher. Since many calls for medical service are not truemedical emergencies, it is important to prioritize the calls in severalways. First, calls that are true emergencies should be dispatched first.Second, if an agency has units with different capabilities, the moresevere medical problems should receive the more advanced units. Andfinally, if lights-and-siren are not needed from a medical standpoint,they should not be used, thereby increasing the safety of all those onthe road.

[0035] The present expert system provides a protocol, which includes aconsistent carefully chosen set of questions, the responses to which areused to calculate a determinate value. The determinate value is used toclassify the degree of emergency and to recommend the appropriate levelof emergency medical response, both in terms of the type of equipmentand the required speed of response. Since the questions asked and therecommendations that are made by the expert system deal directly withlife and death decisions, the protocols used with this invention shallhave passed through a rigorous medical review by a panel of doctors andEMS public safety experts who specialize in emergency medicine.

[0036] While many medical calls are not true emergencies, all situationscan benefit from medical evaluation and instruction. Prior to thearrival of professional help on-scene, the expert system providesinstructions that are appropriate to the type of call, from minorlacerations to someone who is not breathing.

[0037] The preferred expert system used with this invention has abuilt-in reporting capability to statistically measure the performanceof individual staff and overall center performance. These statisticsinclude compliance rates; call processing statistics and peermeasurements. The expert system also determines the incident code, via astandardized coding system from an established protocol.

[0038] The expert system, in the preferred embodiment, can be run as astand-alone application. However, because the information the expertsystem provides can be very effectively used as a tool within the CADenvironment when properly integrated, this invention provides thisintegration.

[0039] The use of this invention begins with the creation of a medicalcall incident. A CAD call taker identifies the call as requiring accessto the expert system, which is then called into operation to begin theEmergency Medical Dispatch (EMD) interrogation. Once the type and levelof incident has been determined, the program returns to the CAD forprocessing of the information. In a horizontal dispatch center, the calltaker then continues the expert system process while a radio dispatcherallocates the necessary equipment and performs the dispatch (and canobtain a summary of information from the expert system about theincident). In a vertical dispatch center, the call taker/dispatchertakes the required time to allocate and dispatch the emergency dispatchunits, returning to the expert system for further instructions. Theexpert system has the capability to sense a change of dispatch, throughthe reconfiguration process (generally brought about by changing theanswers to key questions during subsequent interrogation of the caller).Alerts and new incident codes are also communicated to CAD for anynecessary processing. The preferred expert system is capable of handlingmultiple incidents, through the ability to place the call “on hold” andreturn a later time. Finally, once the call taker has completed thecall, the expert system can be used to recall a closed incident if thecaller accesses the center again.

[0040]FIG. 1 shows a top-level system block diagram showing thepreferred computer hardware employed in this invention. In its presentpreferred embodiment, the process of this invention interfacing betweena CAD program process and an expert emergency medical dispatch system isperformed on a digital computer system 100. In its present embodimentthe digital computer system or workstation 100 includes a processor 105performing the required computations; a memory unit 101 in electroniccommunication with the processor 105 for storing the computer 100operating system, application programs including the CAD program, theexpert medical dispatch program, and the interface program, and datastorage; a display unit 102 in electronic communication with theprocessor 105 for viewing the displayed instructions and inquiries; anuser input device 104 in electronic communication with the processor 105for providing the mechanism of inputting response data; and a hardcopyprinter 103 in electronic communication with the processor 105 forproviding reports. Present embodiments of the invention, run under thefollowing operating systems MS-DOS, Windows, Unix, AIX, CLIX, QNX, OS/2,and Apple. Alternatively, it is expected that future embodiments will beadapted to execute on other future operating systems.

[0041] In the present embodiment of the invention four files are usedfor configuration and communication purposes. These files are (1) amiscellaneous file, generally referred to as MISCFILE; (2) aconfiguration file, contained in the directory referenced by the filesenvironment variable, generally referred to as AMPDSSYS; (3) acommunications file, generally referred to as COMMFILE; and (4) anexport file. Each of these four files is generally described as follows.

[0042] The miscellaneous file may be created using a file name of theCAD vendor's choice and set in an environment variable. This environmentvariable should contain the full path and file name of the miscellaneousfile. Preferably, there should be separate miscellaneous files for eachworkstation on the system. Ideally, the miscellaneous files are locatedon the storage drive 101 of each workstation 100, rather than on anetworked disk drive unit. In the present embodiment of the invention,the miscellaneous file contains information that is unique for eachworkstation in an installation. It contains the ID of the currentlylogged-on operator, a flag indicating if phone line ID numbers are used,the station number of the particular workstation 100 and a flagindicating if the expert medical dispatch software system is running ina resident mode or not.

[0043] The configuration file is a text file that contains severalconfiguration parameters used by the expert medical dispatch software ina CAD environment. If any of the variables need to be set to non-defaultvalues, this file can be created or edited by a text editor in thesub-directory specified in the environment variables. Presentlyavailable variables for use in the configuration file include thefollowing, each of which is identified with a brief description of itsfunction. AllowReleaseToPend allows the user to release the call topending and to return the program beck to CAD control. AllowOverrideallows the operator to override to a higher response. AskGenderAgeOnUnkindicates that the user is always to obtain an age and gender.ExitOnDispatch sets the expert system to exit or pend on SEND events.AccessNoHiSublvls allows access to sub-levels other than thosehighlighted by the expert system recommendation. AllowMenuReconfigallows the Reconfigure Dispatch option. LogoffOnExit sets the system toalways logoff the operator when the operator exits case entry. PollDelayis an integer value that represents the time in seconds that the expertsystem is to wait between polls of the communications file. PollCModesets the communication file to close after every polling cycle or toleave the communication file open all of the time in a share mode or toclose only when the status changes. PollFile provides the path and filename to poll the state of the current case instead of the communicationsfile. CommFileMode can be set to (1) no CAD interface; (2) communicationfile is a disk file; (2) communication file is a named pipe; (3)communication file is a named message queue; (4) communication file is aDDE link; or (5) communication file is a TCP/IP socket. SignalCatchindicates whether when a signal is sent to case entry, a case in processwill be aborted or if the signal will be ignored. AdjustCaseStateindicates whether case states will be automatically adjusted to thecorrect value as necessary or whether an error will occur. ScreenDelayis an integer value that represents the timer value before the end ofinput is assumed on the entry of chief complaint numbers.ResponderScript indicates if the text from the responder script shouldbe included in the COMMFILE. AllowProbDescPassed indicates whether CADis to pass problem description text into the expert system.UpdatePassedCEfields allows the user to modify the location and callbackfields in the expert system that have been passed from CAD, or keeps theuser from modifying the location and callback fields in the expertsystem when they are passed from CAD. WriteCADonCEend causes the ProQAto update the COMMFILE with all available information when the usermoves from Case Entry to Key Questions. AbortMode provides that when theoperator aborts a case an abort DDE message is sent to CAD. AbortCADcodecontains the returned string received by CAD in the CAD Incident Codefield of the COMMFILE. AbortDispCode contains the returned stringreceived by DAD in the Dispatch Level field of the COMMFILE.AllowAbortReason permits that the user can either type in free form textas a reason to abort a case or can only choose from the list ofadministrator defined abort reasons. AllowClose determines if the usercan close the expert system through normal operating system conventionsor must be shut down through CAD. AutoActivate permits the expert systemto automatically change window states when the case state flag is set.AutoDeactivateDisp indicates whether the expert system will minimizeitself on dispatch. AutoDeactivateClose indicates whether the expertsystem will minimize itself on case completion or will remain active oncase completion. AutoNetLogin indicates if the network logon is used toautomatically login to the expert system. Epoch specifies the currentepoch for two-digit year entry. NotifyCADonStop indicates whether theCOMMFILE should receive T state flag when the expert system is shutdownby the user. WriteCOMMFILEoninit indicates whether the COMMFILE will berewritten when a case is initialized. WriteCOMMFILEonKQend if set causesthe expert system to update the COMMFILE with all available informationwhen the user moves from Key Questions to DLSs. FileAccessMode indicateswhether database access is through a locally available file system or isvia a TCP/IP to a database server. ServerName is a string valueidentifying the name of the database server. AutoPrintOnSend can be setto print selected case information when send or reconfigure occurs.AutoPrintOnClose can be set to print selected case information when thecase is closed. AutoPrintSCaseInfo can be set print main caseinformation. AutoPrintS4 cmds can be sent to print the four commandmentsof the expert system. AutoPrintSDispInfo can be set to print dispatchinformation. AutoPrintSRespScr can be set to print the responder script.AutoPrintSTimeStamps can be set to print the time stamp information.AutoPrintSRunTimes can be set to print the running times. AutoPrintSKQscan be set to print the key questions of the expert system.AutoPrintSSeqs can be set to print the case sequences. AutoPrintSPrinteris set to the name of the printer to use when printing dispatchinformation on send. AutoPrintCCaseInfo can be set to print the maincase information. AutoPrintC4 cmds can be set to print the four commandsof the expert system. AutoPrintCDispInfo can be set to print thedispatch information. AutoPrintCRespScr can be set to print theresponder script. AutoPrintCTimeStamps can be set to print the timestamp information. AutoPrintCRunTimes can be set to print the runningtimes. AutoPrintCKQs can be set to print the key questions.AutoPrintCSeqs can be set to print the case sequences. AutoPrintCPrinteris set to name the printer to use when printing dispatch information onclosing a case. The communication file is the device by which CAD andthe emergency dispatch expert system transfer information. Conceptually,the communication file is analogous to a shared memory segment in Unixwith the first byte being a semaphore, controlling access to the rest ofthe memory/file. Preferably it should be a shared memory segment forspeed and I-node use reasons, however, it can also be implemented as afile for portability with platforms that do not support inter-processcommunications. Since it is desirable to improve performance and tomaintain multi-platform capability, the present implementation of thisinvention supports message queues and named pipes in Unix and DDE inWindows. The communication file may be created using a file name of theCAD vendor's choice and set in the environment variable COMMFILE. Thisvariable would typically contain the full path and file name of thecommunication file. Preferably, the communication files are located oneach workstation rather than a networked disk drive. The COMMFILE ispresently treated as a sequential text file that contains alphanumericand special punctuation or separator characters terminated by a new linecharacter. Typically, the first line is a series of flags that indicatethe presence or absence of subsequent lines and the status of thecurrent case. The remaining lines contain data as indicated in the flagsset in the first line. Presently the first line has thirty characters.The following table provides the present possible contents of eachposition and what that content means to the preferred emergency medicaldispatch expert system. This is a bi-directional file, which is used tocommunicate between CAD and the expert system. Position DescriptionContent Meaning  1** State of the current case I Initialize CAD

ex sys P Pend ex sys

CAD A Abort ex sys

CAD D Dispatch ex sys

CAD R Reconfig. ex sys

CAD C Complete ex sys

CAD O Re-open CAD

ex sys E* Error ex sys

CAD W* Waiting CAD

ex sys U* Unpend CAD

ex sys Q* Quit CAD

ex sys S* Case Sum. CAD

ex sys T* Stopped ex sys

CAD B* Bring-top CAD

ex sys M* Case Entry finished message ex sys

CAD K* Key Question finished message ex sys

CAD N* New case # assigned ex sys

CAD  2** Operator number Y Operator no. specified N Operator no. notspecif.  3** Incident number Y Incident no. specified N Incident no. notspecif.  4** Location of incident Y Location of incident spec. NLocation of incident not specified  5** Call back phone number Y Callback phone number specified N Call back phone number not specified  6Problem (description) Y Problem specified N Problem not specified  7Number of patients Y Number of patients specified N Number of patientsnot specified  8 Age (numerical) Y Age specified N Age not specified  9Units of the age Y Units of age specified N Units of age not specif. 10Sex of the patient Y Sex specified N Sex not specified 11 Is the patientconscious? Y Consciousness specified N Consciousness not specified 12 Isthe patient breathing? Y breathing specified N breathing not specified13 Chief complaint number Y Chief Complaint specif. N Chief Complaintnot specified 14 Dispatch level Y Dispatch level specified N Dispatchlevel not specified 15 Reconfigured dispatch level Y Reconfigureddispatch level specified N Reconfigured dispatch level not specified16** Export file name Y Export file name specif. N Export file name notspecified 17** Call phone line number Y Call phone line no. specif. NCall phone line no. not specified 18** Override incident number YOverride incident number specified N Override incident number notspecified 19** Return Information Y Return information specified NReturn information not specified 20** Keystrokes to exit expert system YKeystrokes to exit expert system specified N Keystrokes to exit expertsystem not specified 21 Keystroke ending session Y Keystroke endingsession specified N Keystroke ending session not specified 22 DispatchLevel Suffix Y Dispatch level suffix specified N Dispatch level suffixnot specified 23 Medical Response Text Y Medical response text specifiedN Medical response text not specified 24 Abort Text Y Abort textspecified N Abort text not specified 25 Reevaluation Y Reevaluationspecified Reevaluation not specified 26 Exit Error Code Y Exit errorcode specified N Exit error code not specified 27** Post Send DialogMessage Y Post send dialog message flag specified N Post send dialogmessage flag not specified 28 CAD incident code Y CAD incident codespecified N CAD incident code not specified 29** Automatic Case CompleteY Automatic case complete specified N Automatic case complete notspecified 30 Responder Script Y Responder script specified N Responderscript not specified.

[0044] Below is an example of a communication file:

[0045] INYYYNNNNNNNNNNNNNNNNNNNNNNNN

[0046] 0093000001

[0047] 1025 East Harrington Place

[0048] 712-675-0098

[0049] The beginning “I” above indicates that this incident is beinginitialized. This flag is used to avoid a partially processed incidentbeing passed to the expert system.

[0050] When a new incident is started, the expert system is informed sothat it does not attempt to access non-existent historical information.In initializing the resident version of the expert system, this flagwill presently be set to “W,” and all other flags will be set to “N.”The second position is an “N” which indicates that no operator ID willbe passed to the expert system. This means that the expert system willuse the operator ID. If the miscellaneous file has “logged-out” as theoperator and no operator ID is passed to the expert system, through theCOMMFILE, or the operator ID is invalid, an error will occur. Each validoperator ID passed in the COMMFILE will update the miscellaneous fileautomatically so that the miscellaneous file will contain the mostrecently used operator ID. Each new operator ID passed in the COMMFILEwill be added to the operator database on the first reference. Positionsthree through five are “Y”'s. This indicates that an incident number,location and call back number will be expected in the communication fileon the second, third and fourth lines. The rest of the top line contains“N”'s. This means that no other information will be passed in thecommunication file. Not all of the possible information needs to beexchanged each time. It is up to the CAD vendor to decide whatinformation is important for them to share with the expert system. Onlythose items marked with “**” in the table above should be passed by CADthrough the COMMFILE to the expert system. It is suggested that thelocation and call back number always be exchanged.

[0051] The limitations on the type of data stored in each fields (orlines) is described in the table below. In the present embodiment, allalpha characters are converted to upper case by the preferred expertsystem. Line Description Length or possible content1 1. State/Flags 30characters 2. Operator number 1 to 10 alphanumeric characters specifyingthe operator ID on file with expert system 3. Incident number 1 to 10alphanumeric characters specifying the case number. 4. Location ofincident 1 to 60 alphanumeric characters 5. Call back phone 1 to 20numeric and punctuation number characters 6. Problem description 1-40alphanumeric characters 7. Number of patients Numeric characters ranging1 to 127 or the text “UNKNOWN” 8. Age Numeric characters ranging 1 to127 or an “age range” description 9. Units of the age Description of thecontents of the “Age” field, i.e., years, months or range 10. Sex ofpatient Description of patient “” gender; i i.e., MALE, FEMALE, UNKNOWN11. Is the patient Description of patient's state of conscious?consciousness; i.e., YES, NO, UNKNOWN 12. Is the patient Description ofpatient's state of breathing? breathing; i.e., YES, NO, UNCERTAIN,UNKNOWN 13. Chief complaint Numeric characters ranging 1 to 32 number14. Dispatch level Special format 15. Reconfigure Special formatdispatch level 16. Export file name 1 to 80 legal file name characters17. Phone line number 1 to 4 alphanumeric characters 18. Overrideincident 1 to 10 alphanumeric characters, number which will change thecurrent case number, assigned. 19. Return information String of “Y”s and“N”s indicating which fields should be returned to the CAD system in thecommunication file. 20. Keystrokes to exit List of keystrokes used toexpert system exit expert system. These are in a two- character format.21. Keystroke which A two-character field ended session showing whichkeystroke was used to exit the expert system. 22. Dispatch level suffixOnly applicable on chief complaint numbers 4, 23 and 27. 23. Medicalresponse The actual text of the response as it text appears on the keyquestion screen. 24. Abort text The actual text of the reason foraborting the case. 25. Reevaluation A “Y” or “N” indicating whether toallow reevaluation or not. 26. Exit error code The code number of theerror, which caused the expert system to terminate. 27. Post send dialog“Y” or “N” indicating whether or not message a dialog box should appearon the screen after a send or reconfigure, and prior to an automaticjump to Pre-Arrival Instructions. 28. CAD incident code Returns the CADincident code for the dispatch determinant, if it exists in the user-defined responses. 29. Automatic case I set to “Y” the expert systemcomplete performs a case complete without any further action by theoperator. 30. Responder script Returns human readable text describingthe sit situation.

[0052] The communications file, in the present preferred embodiment, ishandled differently depending on whether the invention is operating inthe non-resident mode or the resident mode.

[0053]FIGS. 2a and 2 b are flow diagrams of the preferred steps of thenon-resident mode integration process of this invention. Thenon-resident mode is specified when the fourth line of the miscellaneousfile is set to “N.” This allows a single thread of execution to be usedfor each dispatch workstation. Initially, the process waits for anincident type 201. When an incident type 201 occurs, CAD writes 202 tothe COMMFILE the initial information to start a case. In the presentembodiment, this means writing a line that has an “I” in the firstposition, four “Y”'s and finally 25 “N”'s. Following this line, thereshould be four more lines containing the operator ID, incident number,location and call back number. Optionally, fields 16, 17, 19 and/or 20may be specified if CAD will use these features. The expert system isthen called 203 to perform its interrogation. When control is returnedto CAD, the state flag will be set to “P,” “D,”“R,” “A,” “C,” or “E”. Astate flag=P test 204 is made to determine if the operator selected theRelease to pending option from the expert system menu. If the state flatis equal to P, the CAD incident is written 207 to a pending COMMFILE 206and is returned to the CAD's normal stand-by/waiting for the nextcommand mode by again calling the expert system 203. If the state flagis not equal to P then a state flag D test 205 is made to determine ifthe expert system has recommended that a dispatch should occur and hasreturned the applicable information in fields 22, 23 and 28. If thestate flag is equal to D, the CAD program, preferably and typically,reads 208 the COMMFILE for these three fields and either allows the userto dispatch the incident or place the call with the recommended calltype in the CAD's pending file for another operator to pick up anddispatch, depending on whether the CAD is using horizontal or verticaldispatching methods. In either case, when CAD is finished, the processof this invention returns to the expert system 203. This completes thepreferred medical protocols of the expert system. At a minimum,post-dispatch instructions will typically be given and there may befurther questions that need to be asked to construct a complete pictureof what is happening in the field. Moreover, sometimes pre-arrivalinstructions will need to be given. If the state flat is not equal to D,the process goes to transition step C 211 in FIG. 2B. In FIG. 2Btransition step C 211 takes the process to a state flag=R test 212,which if true indicates that because of additional information that theexpert system has changed the recommended dispatch level. Typically, theR flag is returned only after the expert system has returned at leastone time with a “D” state flag. If the previously pending case is stillpending, CAD updates 213 the dispatch level and recalls the expertsystem 203 via transition step A 209 to FIG. 2A. If the case has alreadybeen retrieved by another dispatcher or if the current user performed adispatch initially, appropriate measures need to be taken to change thelevel of response in CAD. Again, after this process is complete, theexpert system is recalled 203, via transition step A 209 to FIG. 2A. Ifthe state flag is not equal to R, then the state flag=A test 214 is madeto determine if the user has aborted the case. This would only beexpected to occur prior to a dispatch of emergency medical assistance.Therefore, CAD will typically perform any file maintenance 215 that isrequired and return the user to the incident type entry 201 of FIG. 2Avia transition step B 210. If the state flag does not equal A, then astate flag=C test 216 is made to determine if the case has beencompleted as far as the expert system is concerned. If the case has beencompleted, then CAD performs any necessary file maintenance 217 and wait218 for the next CAD command, that is, the process goes into a normalstand-by mode. If the state flag is not equal to C, then an error hasoccurred, which is reported 219 to the user. A test 220 as to whetherthe expert system initialized the case is made. If it did not, then thenormal stand-by mode is entered 218. If the expert system did initializethe case, CAD returns to the wait for incident type step 201, shown viatransition step B 210 to FIG. 2A.

[0054]FIG. 3 shows a flow diagram of the preferred reopen procedure ofthis invention. In addition to the standard process described above inreference to FIGS. 2A and 2B, the present embodiment of this inventionalso provides CAD with the option of reopening a case that has beencompleted or aborted and can get a case summary of any case.Essentially, similar to initially calling the expert system, except thatinstead of using an “I” to initialize the case, and “O” is used toindicate to the expert system that the case is already on file and toreopen 301 the case retrieving the information from its historicaldatabase. As shown in this FIG. 3, in the present embodiment only twofields are required to open the case in the communication file 302, theoperator ID and the incident number. While the minimum requirement toreopen a case is the incident number, it is desirable to use theoperator ID also to ensure accurate historical information. In additionto these fields, the location, callback number and/or problemdescription may also be passed on the appropriate lines, therebyupdating with new values the historical database. Return processing fromthe expert system is the same as described above, hence the connectorsymbol for transition step A 209 is provided returning the process toFIG. 2A. If the expert system has pended a case, generally at some pointin time CAD will need to retrieve the case and continue processing.Retrieving the case and continuing processing is performed inessentially the same manner as reopen of this FIG. 3, with thedifference being the a “P” is written in the first byte instead of a“O”.

[0055]FIG. 4 shows a flow diagram of the preferred case summaryprocedure of this invention. In the present preferred embodiment of thisinvention, a user may display a case summary at nearly any time duringthe processing of a case. CAD may provide this functionality as aseparate CAD command or menu item. As shown in this FIG. 4, initiallythe case summary command in CAD is called 401. The expert system is thencalled 402 to collect the case summary information. Typically the caseis identified by passing the case number to the expert system. Lastly,the process waits 403 for the next CAD command.

[0056]FIG. 5 shows a flow diagram of the preferred startup procedure ofthis invention when operating in the resident mode. In the presentembodiment resident mode is specified when the fourth line of themiscellaneous file is set to “Y.” This approach permits the use of amultiple thread execution for each dispatch workstation; one fordispatch and another for the expert system. Additional detail on theinteraction of CAD with the expert system when the invention isoperating in resident mode is shown in FIGS. 7A and 7B. When CADexecutes its startup procedure it will typically initialize 501 themiscellaneous file 503 and the communication file 502 with defaultstartup values. The first line of the miscellaneous file is set to“logged out.” While the second and third lines are set as appropriatefor the installation, as previously described. The last line of themiscellaneous file is set to “Y” to indicate resident mode operation.The communication file will consist of a single line containing a “W” asthe state flag and a series of “N”'s in the remaining positions. The CADstartup process then continues normally and the expert system is startedas a separate task 504.

[0057]FIG. 6 shows a flow diagram of the preferred shutdown procedure ofthis invention. When CAD exits the shutdown process is similar to theprocess as previously described. The CAD shutdown process calls theexpert system shutdown routine 601. CAD writes 602 a “Q” to the stateflag in the communication file. When the expert system reads the “Q” itwill shut itself down 603. In the present embodiment of the invention,the expert system will not shutdown the shell environment that it isrunning within, so that either a batch/shell script will typically beset-up to perform initialization and exiting of the operating systemresources or CAD will perform the initialization and exiting under itsown control.

[0058]FIGS. 7a and 7 b are flow diagrams of the preferred steps of theresident mode integration process of this invention. In many waysprocessing a case in resident mode is very similar to the non-residentmode. Just as in non-resident mode, CAD is typically configured suchthat when CAD is waiting 701 for an incident type, the user can specifyentry into the expert system (ProQA), by a key press or specific codeentry. When this action occurs, CAD writes 702 to the communication file(COMMFILE) the initial information to start the case. Unlikenon-resident mode, in resident mode, this means writing a line that hasa “W′” in the first position, usually and typically followed by four“Y”'s and finally followed by 25 “N”'s. Typically, following this linethere will be four more lines containing the operator ID, incidentnumber, location and callback number. Optionally, fields 16, 17, 19and/or 20 may be specified if CAD can use these features. After thecommunication file 702 has all of the required information, then an “I”is written to the first position. The expert system is then called whichpolls and continues to poll for changes in the state flag, which willthen detect the new information, read the communication file and beginprocessing. Typically, CAD meanwhile begins reading the state flag ofthe communication file (COMMFILE) looking for a change from “I” toanother value. In resident mode, expert system continuously polls thecase state flag. As indicated above, the process initially waits for anincident type 701. When an incident type 701 occurs, CAD writes 702 tothe COMMFILE the initial information to start a case. In this residentmode embodiment, this means writing a line that has an “W” in the firstposition, four “Y”'s and finally 25 “N”'s. The expert system is thencalled 703 to perform its interrogation. When control is returned toCAD, the state flag will be set to “P,” “D,” “R,” “A,” “C,” or “E”. Astate flag=P test 704 is made to determine if the AllowReleaseToPend isset to its default value of Yes, indicating that the operator selectedthe Release to pending option from the expert system menu. If the stateflat is equal to P, the CAD incident is written 707 to a pendingCOMMFILE 706 and is returned to the CAD's normal stand-by/waiting forthe next command mode by again continuing to poll for changes in thestate flag 703. After the expert system has pended a case, at some pointin time CAD will retrieve the case and will continue processing. This isessentially the same as the reopen option with the exception that a “U”is written to the first byte rather than an “O”. If the state flag isnot equal to P then a state flag D test 705 is made to determine if theexpert system has recommended that a dispatch should occur and hasreturned the applicable information in fields 22, 23 and 28. If thestate flag is equal to D, the CAD program, preferably and typically,reads 708 the COMMFILE for these three fields and either allows the userto dispatch the incident or place the call with the recommended calltype in the CAD's pending file for another operator to pick up anddispatch, depending on whether the CAD is using horizontal or verticaldispatching methods. In either case, when CAD is finished, the processof this invention returns to polling the communication file 703. Thiscompletes the preferred medical protocols of the expert system. At aminimum, post-dispatch instructions will typically be given and theremay be further questions that need to be asked to construct a completepicture of what is happening in the field. Moreover, sometimespre-arrival instructions will need to be given. If the state flat is notequal to D, the process goes to transition step F 711 in FIG. 7B. InFIG. 7B transition step F 711 takes the process to a state flag=R test712, which if true indicates that because of additional information thatthe expert system has changed the recommended dispatch level. Typically,the R flag is returned only after the expert system has returned atleast one time with a “D” state flag. If the previously pending case isstill pending, CAD updates 713 the dispatch level and continue checkingthe communication file for further changes 703 via transition step D 709to FIG. 7A. If the case has already been retrieved by another dispatcheror if the current user performed a dispatch initially, appropriatemeasures need to be taken to change the level of response in CAD. Again,after this process is complete, the CAD should gain continue checkingthe communication file for further changes 703, via transition step D709 to FIG. 7A. If the state flag is not equal to R, then the stateflag=A test 714 is made to determine if the user has aborted the case.This would only be expected to occur prior to a dispatch of emergencymedical assistance. Therefore, CAD will typically perform any filemaintenance 715 that is required and return the user to the incidenttype entry 701 of FIG. 7A via transition step E 710. If the state flagdoes not equal A, then a state flag=C test 716 is made to determine ifthe case has been completed as far as the expert system is concerned. Ifthe case has been completed, then CAD performs any necessary filemaintenance 717 and wait 718 for the next CAD command, that is, theprocess goes into a normal stand-by mode. If the state flag is not equalto C, then an error has occurred, which is reported 719 to the user. Atest 720 as to whether the expert system initialized the case is made.If it did not, then the normal stand-by mode is entered 718. If theexpert system did initialize the case, CAD returns to the wait forincident type step 701, shown via transition step E 710 to FIG. 7A.

[0059] The resident mode has the same option to reopen as non-residentmode and works basically in the same manner. As with typical caseprocessing, the difference between non-resident mode and resident modeis that in resident mode rather than calling the expert system afterwriting to the communication file, the CAD process goes into a pollingmode to detect a change in the state flag.

[0060]FIG. 8 shows a flow diagram of the preferred case summaryprocedure of this invention. As in resident mode, there are two optionsfor displaying Case Summary information: (1) it can be done the same asin non-resident mode where the expert system is called with a commandline argument in the CAD environment's thread of execution; or (2) canbe used that is more like the reopen option. The reopen option is shownin this FIG. 8. The case summary command in CAD is called 801, followingwhich the communication file is passed a “S” state flag 802 along withthe incident number and then CAD waits 803 for a change in the stateflag.

[0061] The previous described preferred embodiments of the invention areto be considered in all respects only as illustrative and not asrestrictive. Although the embodiments shown describe particularcomponents in particular connection configurations, the invention is notlimited thereto. The scope of this invention is indicated by theappended claims rather than by the foregoing description. All systemsand devices, which come directly within the claims or within the meaningand range of equivalency of the claims, are to be embraced as beingwithin the scope of protection of this invention.

1. A method for integrating a computer aided dispatch system and anemergency medical dispatch protocol, comprising: (A) initiating acomputer aided dispatch system; (B) receiving an incident call; (C)calling an expert emergency medical dispatch system; (D) testing fordesired process states; and (E) returning control to said computer aideddispatch system.
 2. A method for integrating a computer aided dispatchsystem and an emergency medical dispatch protocol, as recited in claim1, further comprising writing a computer aided dispatch incident to acommunication file.
 3. A method for integrating a computer aideddispatch system and an emergency medical dispatch protocol, as recitedin claim 1, further comprising reporting errors to a user.
 4. A methodfor integrating a computer aided dispatch system and an emergencymedical dispatch protocol, as recited in claim 1, wherein said testingfor desired process states further comprises testing if an operator hasselected a release to pending option.
 5. A method for integrating acomputer aided dispatch system and an emergency medical dispatchprotocol, as recited in claim 1, wherein said testing for desiredprocess states further comprises testing if an operator said computeraided dispatch system needs to retrieve a case.
 6. A method forintegrating a computer aided dispatch system and an emergency medicaldispatch protocol, as recited in claim 1, wherein said testing fordesired process states further comprises testing whether said expertemergency medical dispatch system has recommended that a dispatch shouldoccur.
 7. A method for integrating a computer aided dispatch system andan emergency medical dispatch protocol, as recited in claim 1, whereinsaid testing for desired process states further comprises testingwhether said expert emergency medical dispatch system has changed arecommended dispatch level.
 8. A method for integrating a computer aideddispatch system and an emergency medical dispatch protocol, as recitedin claim 1, wherein said testing for desired process states furthercomprises testing whether a user has aborted a case.
 9. A method forintegrating a computer aided dispatch system and an emergency medicaldispatch protocol, as recited in claim 1, wherein said testing fordesired process states further comprises testing whether a case has beencompleted.
 10. A method for integrating a computer aided dispatch systemand an emergency medical dispatch protocol, as recited in claim 1,wherein said testing for desired process states further comprisestesting whether an error has occurred.
 11. A system for integrating acomputer aided dispatch system and an emergency medical dispatchprotocol, comprising: (A) a computer device; and (B) a computer programoperating on said computer device, wherein said computer program furthercomprises: (1) an operating system, managing the operation of saidcomputer device; (2) a computer aided dispatch system operating incooperation with said operating system to manage emergency responseresources; (3) an emergency medical response protocol system for guidinga dispatchers response to a caller, wherein said emergency medicalresponse protocol system further comprises a set of specified inquiries,a calculated determinate value based one or more responses to said setof specified inquiries, and a defined emergency medical response basedon said determinate value; and (4) an interface between said computeraided dispatch system and said emergency medical response protocolsystem, wherein said interface is a process for communicatinginformation between said computer aided dispatch system and saidemergency medical response protocol system.
 12. A system for integratinga computer aided dispatch system and an emergency medical dispatchprotocol, as recited in claim 11, wherein said computer device furthercomprises: (1) a processor; (2) a memory unit in electroniccommunication with said processor; (3) a display device in electroniccommunication with said processor; and (4) an input device in electroniccommunication with said processor.
 13. A system for integrating acomputer aided dispatch system and an emergency medical dispatchprotocol, as recited in claim 11, wherein said operating system isselected from the group consisting of MS-DOS, Windows, Unix, AIX, CLIX,QNX, OS/2, and Apple.
 14. A system for integrating a computer aideddispatch system and an emergency medical dispatch protocol, as recitedin claim 11, wherein said interface further comprises a methodcomprising: (a) initiating a computer aided dispatch system; (b)receiving an incident call; (c) calling an expert emergency medicaldispatch system; (d) testing for desired process states; and (e)returning control to said computer aided dispatch system.